title: Collaborative Cardiovascular Risk Reduction in Primary Care II (CCARP II): Implementation of a systematic case-finding process for patients with uncontrolled risk factors.
abstract: BACKGROUND
  Previous pharmacist interventions to reduce cardiovascular (CV) risk have been limited by low patient enrolment. The primary aim of this study was to implement a collaborative pharmacist intervention that used a systematic case-finding procedure to identify and manage patients with uncontrolled CV risk factors.
  
  
  METHODS
  This was an uncontrolled, program implementation study. We implemented a collaborative pharmacist intervention in a primary care clinic. All adults presenting for an appointment with a participating physician were systematically screened and assessed for CV risk factor control by the pharmacist. Recommendations for risk factor management were communicated on a standardized form, and the level of pharmacist follow-up was determined on a case-by-case basis. We recorded the proportion of adults exhibiting a moderate to high Framingham risk score and at least 1 uncontrolled risk factor. In addition, we assessed before-after changes in CV risk factors.
  
  
  RESULTS
  Of the 566 patients who were screened prior to visiting a participating physician, 186 (32.9%) exhibited moderate or high CV risk along with at least 1 uncontrolled risk factor. Physicians requested pharmacist follow-up for 60.8% (113/186) of these patients. Of the patients receiving the pharmacist intervention, 65.5% (74/113) were at least 50% closer to 1 or more of their risk factor targets by the end of the study period. Significant risk factor improvements from baseline were also observed.
  
  
  CONCLUSIONS
  Through implementation of a systematic case-finding approach that was carried out by the pharmacist on behalf of the clinic team, a large number of patients with uncontrolled risk factors were identified, assessed and managed with a collaborative intervention.
  
  
  CONCLUSIONS
  Systematic case finding appears to be an important part of a successful intervention to identify and manage individuals exhibiting uncontrolled CV risk factors in a primary care setting.
authors.affiliation: College of Pharmacy & Nutrition (Yakiwchuk, LeBras, Jorgenson, Mansell, Blackburn), University of Saskatchewan, Saskatoon, Saskatchewan.
authors.forename: Erin M
authors.initials: EM
authors.lastname: Yakiwchuk
authors.forename: Derek
authors.initials: D
authors.lastname: Jorgenson
authors.forename: Kerry
authors.initials: K
authors.lastname: Mansell
authors.forename: Tessa
authors.initials: T
authors.lastname: Laubscher
authors.forename: Marlys
authors.initials: M
authors.lastname: Lebras
authors.forename: David F
authors.initials: DF
authors.lastname: Blackburn